Team Structure Development Establishing the Basis for Collaboration

1. Team Structure & DevelopmentEstablishing the Basis for Collaboration Rosalyn M. Bertram Ph.D. Principal Investigator University of Missouri Kansas City School of Social Work Study supported by Kids Safe Funds via Heart of America United Way & University of Missouri Kansas City Center for the City CORPS grant

2. Child Sexual Abuse Response:Complex Interdependent Relationships Legally mandated responsibilities & timelines Separate funding, policy, training, supervision Overlapping roles Police & Children�s Division Complementary roles Children�s Division & Family Court Police & Prosecutor�s Office Relying upon: Medical evaluations by Children�s Mercy Hospital Forensic evaluations & coordination at Child Protection Center

3. Child Protection Center�sConfused Decision-Making Forums Community Council Former Judges Doctors Former Prosecutors Fundraisers Activists AND Some members of the Governance Group Governance Group Key Administrators from: Children�s Division Kansas City Police Family Court Prosecutor�s Office

4. �Case Collaboratives� Primary means for negotiating overlapping or complementary roles & responsibilities Case-by-case means to integrate multi-system response but, composition & structure varied Relied upon trust developed between professionals Politically hot cases, funding cuts & staff turnover eroded this case-by-case approach to systems integration

5. Theory base for team development NIDRR studies by five universities of effective teamwork in developmental disabilities (Eno-Heineman, 1997) Applied in CMHS-SAMHSA grants in defining theory base for Wraparound (Malysiak, Malysiak-Bertram, 1997-2001) (Bertram & Bertram , 2003) Never applied with administrators representing multiple systems working with same population

6. Systemic Team Development  Power & challenge of collaborative models of practice: They bring together differing perspectives of a situation Team composition affects assessment and outcomes Clear structure maximizes team efficiency & efficacy Team structure: 4 evolving, inter-related sets of agreements Greater cohesion in agreements contributes to better performance Shared goals & rules are basis for collaboration Assessment is ecological & systemic, summarized by team agreement on current status that is used with goals to develop plan Evaluation of plan implementation informs changes to team composition & structure

7. Team Structure Goals Rules of Operation Information-sharing Information needed How to share it Decision-making Especially how to make decisions when not all agree Conflict resolution Assessment Ecological Competencies & Assets Constraints & Challenges Status agreement Summary of assessment, places problems-in-context, brings assumptions forward Used with goals to develop plan Plan & evaluation Strengths as levers for change Lessons guide further team efforts

8. Team Composition Differentiate! One team with subsystems Core Those who best know the situation or who influence use of key resources Extended Those implementing plan strategies. They provide service & information but are not team decision-makers

9. Multi-system administrative team Children�s Division Regional Director Captain KCPD Special Victims Crime Unit Jackson County Prosecutor�s Office Jackson County Family Court Chief Juvenile Officer Director of Social Work Children�s Mercy Hospital Director Child Protection Center Chief Investigative Detective Independence Police Chief Investigative Detective Lees Summit Police Director of Community Development United Way

10. Child Protection Network (CPN)Goals Administrators agreed they should be working together through the Child Protection Center to provide: Timely, efficient, co-investigation of child sexual abuse allegations to better inform decisions each agency must make to support children and families in a culturally competent manner.

11. Rules of operation Agreed it was necessary to share information about practice with families, and about agency policy, resources, & projects Clarified discussions by whether they were confidential, simple information sharing, exploratory, or decision-making Decision-making rules: A menu of options Dissenting perspectives recorded. If decision wasn�t productive, dissenting viewpoints would be revisited. 4. Conflict resolution procedures established

12. Ecological systemic assessment Direct practice with families Co-investigation, medical & forensic evaluation, family court, prosecution, family services, & case collaboratives Administrative level guiding that practice Governance Group ? Child Protection Network Community advocacy: seeks changes in laws & funding Community Council (later became CPC board of directors) Clarified composition, information needed, roles & responsibilities, assets & constraints for each level

13. Status agreement Summarizes assessment to help examine assumptions Ideally, a systemic hypothesis of problems-in-context Is used with overall team goals to develop action plan CPN: �We lacked clarity for different levels of our activities. This contributed to confusion on roles & responsibilities. We lacked shared means to ensure systematic, efficient information gathering as well as shared guidelines for decision making. This compromised our best intentions to enhance our assets and address constraints.�

14. Child Protection Network: Initial action plan Define best practice from hotline report, through investigation, forensic evaluation, & collaborative review for prosecution and services Clarify roles & timelines in that best practice protocol Write shared manual for detailed protocol guidance Provide joint training in new guidelines to all staff Identify QA data points for a shared database administrators review monthly in CPN meetings to evaluate practice fidelity & inform improvements Fully Accomplished in One Year

15. Participant Interviews Prior to Systemic Team Development Little collaboration occurring Attempts to integrate roles & responsibilities failing Each agency advocated for its own perspective & goals No rules for information sharing or decision-making Assumed discussions would forge understanding Assumed voting would determine direction Decisions often revisited, stalling efforts Repeated failures raised suspicion Conflict clouded their vision They lacked trust No multi-systems strengths-based assessment

16. After Systemic Team Development Trust & a sense of influence emerged from developing shared goals & working within shared rules Shared goals & rules provided direction & structure for collaboration in assessment & planning Shared direction & structure improved assessment, clarified concerns & identified overlooked assets Previously pessimistic administrators found hope because there were assets from which to build Summarizing assessment with status agreement helped them consider why they had been stuck in conflict Planning based upon status agreement & shared goals contributed to �ownership� & to timely, successful implementation

17. Results & Next Steps STD worked with administrators from multiple-systems exactly as designed in direct family practice Action plan fully completed in 1 year Shared database evaluating CPN protocol fidelity guides individual agency & multi-system adjustments, and may soon be used statewide Continuous quality improvement via data-informed revision of CPN goals, rules, assessment & plan

18. Implications Value-based principles & legal mandates do not ensure collaboration, integration, efficiency nor efficacy Relationships & parliamentary procedure do not ensure collaboration, integration, efficiency, nor efficacy Theory base that may better support collaboration & integration of efforts: Systemic Team Development (STD) Ecological Systems Theory